Archive for August, 2006
After weight loss surgery, people drop pounds. But some patients lose something else - their hair! It’s usually mild and temporary, but sometimes it can be severe.
When Ruby Bordes had gastric bypass surgery, she lost 117 pounds, but she also started losing her hair.
“It fell out in clumps and it got really thin, especially on top, and it made me look a lot older,â€? says Bordes.
According to hair restoration surgeon Doctor Bernard Nusbaum, hair loss is common following bariatric surgery.
“In speaking to doctors and nurses and colleagues in the field it may be as high as 50% of patients,” says Dr. Nusbaum.
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Most commonly the hair loss is caused by vitamin and mineral deficiencies, but since fat is hormonally active tissue. Shifting hormones may also play a role.
Hair specialist Leo Benjamin says it usually doesn’t happen right after the surgery.
“Usually in about the seventh or eighth month is when we start to see them after gastric bypass surgery. They start to lose hair in clumps and stuff like that,” says Benjamin
Special diets and nutritional supplements can help, but to fix the problem many people need hair replacement, until their real hair comes back.
“We’re just there for the people that need something cosmetically done to get them through, through the hurdle,â€? says Benjamin.
Ruby used a method where human hair was bridged with her own.
“It’s like extensions for the top of your head,” says Benjamin.
“I don’t feel like I want to hide from the world anymore,” says Ruby
Now she’s thinner, but no longer looks thin up top.
August 24th, 2006
Compiled by LaMont Jones, Pittsburgh Post-Gazette
Lots of new items on the fragrance front, some more interesting than others.
Tova Borgnine, wife of actor Ernest Borgnine, has created a niche in the beauty industry and gained a following on QVC. Her new and fifth perfume, Love Everlasting, contains Arctic snow flowers, blue iris, white pepper, black raspberry, cashmere woods and a glacial accord ($38). It launches on the shopping channel at 5 a.m. and 3 p.m. Aug. 27 and will be available on QVC.com.
Tommy Hilfiger celebrates the 10th anniversary of Tommy and Tommy Girl with updated reformulations of both. Tommy 10 and Tommy Girl 10 contain new ingredients from across America such as Seattle rain, Kentucky bluegrass, Hawaiian pineapple, Cape Cod cranberry and Rocky Mountain blue spruce in his version and Indian River grapefruit, Mississippi magnolia, Virginia water lily and California honeysuckle in hers. Macy’s and tommy.com will have them in September ($39.50 each).
Miss Sixty, popular for jeans and sportswear, has launched an eau de toilette of the same name that contains red currant, rhubarb, amber and a blend of fresh, fruity green notes; $45 at Sephora.
Fashion designer Betsey Johnson delivers her first perfume, a fruity “floriental” with tangerine, freesia, red apple and praline ($55 at Macy’s and Sephora); Elizabeth Arden introduces spicy-woodsy-amber With Love … Hilary Duff ($35 at both stores); and Desperate Housewives Forbidden Fruit by Coty Prestige seduces with a blend of peach, spicy pepper, wisteria and vanilla ($49.50 at Macy’s).
And file this one under Decadence 101: Missoni, a fruity floral women’s scent that debuted in Sak and Neiman Marcus and Saks in March, rolls out four body products infused with the same floral, fruity and Gianduia chocolate notes as the perfume. If the $45 shower gel and $50 body lotion aren’t enough, there’s an $80 body butter and a round pillar candle for $150. Find them locally at Saks in September.
Hair models wanted
Wanna be a hair model? Five lucky women will get to be just that in a 2007 advertising campaign for Finesse hair care products.
Women 18 and older may enter the Finesse Models LifeStyle Contest by going to finessecontest.com and uploading one “before” and one “after” picture of herself demonstrating changing hair styles. Applicants also must respond to a question about her changing hair style and why she should be selected as a winner.
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The public’s online votes, along with the opinions of a panel of professional judges, will determine the winners. The deadline to enter is Dec. 31 and winners will be announced Feb. 14, 2007.
Pretty boys
The marketplace now offers men their own beauty products, and — according to a new Glamour poll — men are using them.
Men account for 10 percent of cosmetic sales, according to the magazine’s August issue, which also reports that 63 percent of 1,529 women polled said their man regularly buys and uses skin and hair products. Seventy-eight percent of those same women also said they wouldn’t date a man who uses more beauty products than they do.
It seems women don’t have to worry: Another survey, conducted for Boss Skin, a new men’s grooming line from Hugo Boss, found that 36 percent of the 559 men questioned knew their skin should be moisturized, but only 10 percent said they washed, exfoliated and moisturized each day.
There’s an art to balancing beauty and masculinity. When Frederic Fekkai opened his new flagship salon and spa in the Henri Bendel store in Manhattan, he added a men’s styling lounge called L’Atelier de Frederic. The decor includes stainless steel sink faucets, white subway tiles and tufted sofas.
Fekkai stylist Stephane Andre offers tips for men:
August 20th, 2006
He was six foot one, blond, tanned and toned, with a Clutch Cargo jaw and blue eyes that sparkled like trophies in the sun.
As New Zealand Tennis’ No 1 player, Mark Nielsen led a life of glamour and excitement, globetrotting for nine months a year and playing some of the world’s greatest tennis players. Once ranked 16th best junior in the world, he was, until early this year, New Zealand Tennis’ golden boy.
His downfall? A desire to keep those golden locks. When he started losing his hair in his early 20s, Nielsen kept secret from almost everyone the fact that he was taking anti-balding medication. He was too embarrassed to bring it up with his coach and manager, and he was too embarrassed to announce it on a drugs declaration at the Australian Open in January.
So the humiliation was complete when urine tests revealed finasteride, a common ingredient in male pattern baldness medication, recently banned as a potential masking agent.
Slated as a drug cheat and outed as a young man with premature hair loss, he was banned from tennis for two years.
“[As it was] a personal drug, I didn’t tell anybody,” Nielsen says, “and that cost me two of my best years. For keeping a secret. For keeping it personal, really.
“It wasn’t a secret. If you had confronted me, I wouldn’t have run away from the fact I was taking it.”
These days Nielsen can be found at Belmont Park Racquets Club, a suburban seven-court facility on Auckland’s North Shore, where he is coaching novice players. It’s his first non-playing job since he turned professional at 17.
He has been here a week. On court lobbing balls at a client, Nielsen is trying hard to be enthusiastic.
“That’s good foot work on the backhand,” he shouts to the young man sweating and grunting on the other side of the net. But his expression rarely changes under his black cap. And his long arms hang like nonchalant levers from his broad, rounded shoulders.
Later he explains: “I feel like a caged animal really. I just want to fight, I guess is the word, but it’s not fighting, it’s just playing a sport.
“I feel like I’ve got all this energy inside me but I can’t release it. Because I made a mistake.”
Some mistake. In a cruel twist, Nielsen now has permission from the International Tennis Federation to use his hair-loss drug when and if he returns from his ban in 2008.
All he had to do was ask.
Meanwhile, he can’t play international tennis or national competitions for 24 months, and Tennis New Zealand has advised local clubs to prevent him from playing interclub, too, “in the spirit of the suspension”.
That makes Nielsen bristle. “I would have hoped they showed a bit more loyalty, a little more heart.”
He hopes local clubs will let him play anyway. He needs to practise, he needs games. He wants to be back when the ban is over. Even if he does get to play interclub, it may not be enough to regain his national or international ranking.
Yes, he’s angry. But his seething restraint is palpable.
“I spent basically my whole being playing tennis. It was all I wanted to do, all I ever thought about.”
Ever since he was a baby resting in his carrycot under the trees at Milford Tennis Courts, this was his destiny. Lulled to sleep by the pok, pok, pok of his mother’s game, as soon as he was old enough to hold a racket, he was giving it a go himself.
By 12 he was handpicked to be part of Tennis New Zealand’s elite junior training squad. He enjoys the story of how he was late for third-form geography at Kings College in Otahuhu every Monday after training.
His teacher knew where he had been, but a ritual apology needed to be performed each week.
“This one particular time he got pissed off,” Nielsen remembers. “I had to go in and say to the teacher ‘Sorry, Sir, I’m late’, and he said to me in this big voice in front of the class ‘Nielsen! What’s more important, school or tennis?’ And I turned around straight away and said ‘Tennis, Sir’, because tennis was more important.” The teacher asked him again. Nielsen knew he would be trapped all day if he didn’t give the right answer. “School, Sir,” he replied. And sat down.
In reality there was no time for school. He left after fifth form to concentrate on tennis fulltime.
He had already represented New Zealand, playing in Brisbane at age 12. The memory is still clear.
“I still remember the experience of travelling with a racquet on my back. It’s really, really strange now to travel anywhere and not have a racquet on my back. It doesn’t feel right.
“Even not having a racquet in my hand, my arm just feels short and useless. And all of a sudden it comes alive when I put a racquet in it.”
By the time he was 16, he was travelling six months of the year. At age 17, he earned his first Association of Tennis Professionals point and was internationally ranked.
“At 17, I spent nine months overseas, and I spent nine months overseas every year since - till I got banned.”
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Now he has had to put down roots. Suddenly, he is a 29-year-old grown-up in need of a job and a home - he’s living in his parents’ studio apartment - trying to come to grips with a bizarre new reality.
“It’s pretty boring,” he confesses. “How do you live in one place for 12 months? How do you get up and do the same thing every day? Socially, it’s just so different, living in one place and seeing the same people every day.
“A lot of guys on the tour, they act a certain way because they can, because next week they won’t see you. If you piss them off, they’ll tell you what they think. There’s no PC stuff because who cares? Next week, or even the next day, he’s on a train or a plane going somewhere else.
“So there’s heaps of stuff that I have to learn, that I probably didn’t fully learn because I started travelling so early.”
There’s one silver lining - he has a girlfriend, a supportive, caring woman he met since the ban. He smiles. “Probably what you might call my second girl-friend. All the others have been short-term relationships that don’t last because of travelling.”
Nielsen was resting up from an injury in March when the federation called about his blood results following the Australian Open.
It was brutally officious. “They told me, ‘Look, you’ve tested positive and you need to find a lawyer’.
“I didn’t know the name of the drug. I knew the name of what the doctors were giving me. They were happily writing prescriptions and handing it to me, and I was taking it.”
Nielsen’s hair-loss product, a prescription medicine he had been taking for more than three years on the advice of two doctors, contains finasteride. Though not a performance enhancing drug, finasteride wasbanned early last year when it was discovered that it could mask the presence of steroid drugs.
As Nielsen explains it, he had lulled himself into a false sense of security. For three years he had been subjected to drug tests. Nothing had ever come up, so he assumed he was fine.
He had no idea that finasteride had been added to the banned substances list, he says. He didn’t even notice when Argentine player Mariano Hood was banned for a year after testing positive for the substance at last year’s French Open. Nielsen says he was playing in America and Europe at the time and didn’t hear the news.
But his ignorance didn’t wash with the International Tennis Federation’s anti-doping tribunal, which said it was a professional player’s job to know what drugs were banned.
Nielsen had failed to include the medication on a declaration form at the Australian Open because he didn’t want to tell a stranger he was taking it and told the tribunal he was embarrassed that he didn’t know how to spell the name of the drug.
The tribunal slammed him for making no effort to check if the drug was permitted and, despite agreeing that he hadn’t taken anything that enhanced his performance, slapped him with the ban.
It came as a huge shock. Nielsen says he was told to expect 12 months at the most. He could have challenged the sentence and flown to London to appeal the length of the ban. But at best that would have trimmed six months off and cost him at least $40,000.
Once ranked 172, Nielsen was ranked 329th in the world at the time. “I don’t make that kind of money in six months. It made sense not to do it.”
Nevertheless, it irks him that he’s categorised as a drugs cheat along with Olympic track athletes who had pumped themselves full of steroids and cyclists such as Floyd Landis, who lost his Tour de France title when his testosterone level was found to be seven times higher than normal.
“I’m not even in the same stratosphere as those guys.”
Even Mariano Puerta, the Argentine found to have taken performance enhancing steroids after the 2005 French Open, had his ban cut on appeal from eight years to two.
But Nielsen is resigned to his fate. “Well, yeah, I’m very angry. I could be sitting in front of you firing my pistol off in this direction and that direction, but what’s that going to achieve?”
He does, however, question whether there should have been systems in place that would have insulated him.
“It was ultimately my fault; I take responsibility, that’s fine.
“But there were other people that could have helped. I had two doctors giving me it who knew exactly who I was; I had one chemist that was giving it out - he knew exactly who I was.
“We had a physio trainer in the Davis Cup. If he’d known, he would have found out straight away that it was banned, but he didn’t know because I didn’t tell him.
“There was no system in place to bump it out of me, to encourage me to speak out about it.”
And so Nielsen finds himself at Belmont Park Racquets Club looking for clients. He enjoys coaching, he says, and he wants more individuals or groups to teach.
But his focus is still on his own game. When the ban lifts, he will be 30, out of practice and unranked. He tries to keep his hand in playing top junior players, including Austin Childs, the star 18-year-old who travels from Tauranga most weekends. But it’s just not the same.
“The reason why I was good was because it was my job to be good. I like to perform under pressure and to play a match with something on it. I don’t like to play for fun. I’m not one of these young PC kids who don’t get to score.”
He may or may not rise back to No 1 again, but Nielsen would like to have his reputation back. People who know him believe in him, he reckons. “They know that if I was going to take drugs, it would have been when I was 20, not 28. I’d be a moron to start now.
“And, why take drugs if you’re not getting a huge return in terms of money? Why would you do it? It just doesn’t make sense. It’s just an honest mistake, and I hope that the public who don’t know me, I hope they believe it, too.”
August 20th, 2006
More than 200 people attended a community meeting last week to review the circumstances that resulted in the homicide of Jamil Burton and to develop a way of averting similar tragedies in the future.
Burton, 19, an openly gay man from South Philadelphia, was gunned down Aug. 4 near Louis Kahn Park, 11th and Pine streets, after he allegedly snatched a gold chain and diamond ring from Barry Mason.
Mason, 70, a tool salesman from Old City, has been arrested and charged with murder and possession of an instrument of crime. He allegedly ran over Burton with his car near the park, then shot him multiple times with a semi-automatic handgun.
This week, Mason remained incarcerated, but his attorneys are attempting to have him released on bail, according to court records.
The community meeting was organized by Mike Gallagher, who lives near Kahn Park. He heard the gunshots that killed Burton. “It was a wake-up call for me, both literally and figuratively,� Gallagher, 29, told PGN.
Gallagher serves on the Mayor’s LGBT Advisory Board, but he organized the event independent of his board duties, he said.
“The meeting was about bridge building, and that’s what happened,� said Gallagher. “It was a great event.�
People from all walks of life attended, including civic leaders, politicians, educators, law-enforcement officials, health professionals, clergy and social-service workers, he said.
Participants stressed that all segments of the neighborhood must work together to avoid future crimes, regardless of their sex, race, sexual orientation, gender identity or job choice, he said.
“Until we embrace diversity and understand that we are one community, we really can’t begin to heal,� Gallagher said.
Judith Applebaum, president of the Washington Square West Civic Association, urged all participants to attend the association’s next board meeting, scheduled for 7 p.m. Sept. 12 at Jefferson Alumni Hall, 1020 Locust St.
“We’ll have a discussion about the concrete things we in the community can do to alleviate crime,� Applebaum told PGN after the Aug. 10 meeting. “The Washington Square West Town Watch leaders will be at the meeting as well.�
Chief Insp. James Tiano, the community’s liaison to sexual and gender minorities, also spoke at the Aug. 10 meeting.
He said police have increased patrols in the area. They’re also stepping up sensitivity training for officers dealing with sexual and gender-minority youths who often visit the neighborhood late at night.
Authorities also want to create alternate, late-night activities for youth, possibly to be held at the William Way Lesbian, Gay, Bisexual and Transgender Community Center, 1315 Spruce St., Tiano added.
“I thought the meeting was a positive step,� Tiano told PGN. “At every turn, there was sympathy expressed for the relatives of Jamil Burton.�
Temple University’s former president, David W. Adamany, lives in the general vicinity of the Burton shooting site. He praised the Aug. 10 meeting, which he attended.
“It gave a chance for people to express their emotions, their sadness and their concerns. It also provided a positive outlet to deal with the issue of crime in the neighborhood. As a citizen of the area, I was pleased there was a strong turnout. There was a great deal of respectful attention to each of the speakers. The whole crowd, a very mixed group of people, listened respectfully to each set of communities,� said Adamany.
Michael Hinson, the city’s liaison to sexual and gender minorities, also praised the meeting.
“Violence is a very important issue to the administration,� Hinson told PGN. “Any attempt by the community to organize against crime, or to combat crime, is welcome by the administration. I thought it was a great meeting under the circumstances. It was a really dynamic meeting, and opened the door for future discussions that all of us agree need to continue happening.�
Held at Jefferson Alumni Hall, the 90-minute meeting culminated with a procession to Kahn Park, where a vigil took place. Some of the mourners held candles for the fallen teen.
The next day, Valerie Burton, Jamil Burton’s aunt, remembered her nephew as a vivacious person. He would have turned 20 in November, she said.
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She said he called her “Vickie� and could be very playful with her.
“Jamil was an outgoing person — everyone loved him,� she said. “He could lift up anyone’s spirits. The family is just devastated by his loss.�
Her nephew had a flair for fashion, often advising her on clothing choices. He also was a talented hairstylist. “He did my hair all the time,� Valerie Burton said.
He enjoyed singing, dancing and riding his bike around the neighborhood. He recently worked as an amusement ride operator at a local carnival, she added.
Jamil especially enjoyed attending the regular cookouts in front of the Burtons’ South Philadelphia rowhome near Shunk and Fairhill streets.
“I’m devastated [by his death],� she continued. “I can’t sleep at night. I wake up looking for him to come through the door.�
Jamil had a large extended family and several relatives lived with him in a South Philadelphia row home, including his 68-year-old grandmother, Audrey Burton.
All of his relatives accepted Jamil’s sexual orientation, his aunt added. “We loved Jamil just the same.�
She said hundreds of people attended his Aug. 9 funeral and burial. “It was so crowded,� she noted.
Mason, the senior who allegedly killed Burton, intends to plead not guilty, said his attorney, Gerald A. Stein.
Stein said Mason regrets the incident but feels that Burton contributed to the shooting by allegedly snatching his gold chain, which was adorned with a diamond ring that belonged to Mason’s former girlfriend.
“[The ring] was something that he had great emotional attachment to,� Stein said. “We extend our sympathies to the Burton family. We do not wish in any way to belittle their bereavement. But Mr. Burton was responsible for triggering the situation. He set in motion the chain of events that led to his death.�
According to Stein, Burton propositioned Mason while Mason was stopped at a red light on South 11th Street on his way to a 24-hour diner. When Mason declined the offer, Burton approached him at another red light and allegedly snatched his jewelry.
Stein said Mason suffers from congestive heart failure and chronic back problems and wishes to be released on bail as soon as possible.
Mason has no prior criminal record, according to Stein, and isn’t a flight risk, he said. In Stein’s opinion, Mason isn’t guilty of murder.
“The worse-case scenario would be a voluntary-manslaughter conviction,� he predicted.
August 18th, 2006
What hair symbolizes
In our society, women’s hair symbolizes many things. It is an external sign of femininity, beauty and sex appeal. Hair is sometimes called a woman’s “crowning glory.� And we all grew up with images of attractive women having lush, full, beautifully-styled hair.
Hair loss and how we view it
Since we’ve been conditioned to believe that we need to have a full head of hair to be “accepted� as women (quite a double-standard, since many men actually choose to go bald because it’s “sexy� on a man), there is a great sense of loss when our hair starts to go. We feel unattractive, less-than-feminine and inadequate and inferior, as a result. We feel like we don’t fit in. We feel a loss of control. Based on what we’ve been taught to believe, these feelings are completely normal. And while they’re normal, they are also quite damaging, so we need to work through them and arrive at a better, healthier place so that we can live and enjoy our lives to the fullest.
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You’re not alone
In addition to knowing that your feelings are normal, you must also known that you’re not alone. There are millions of women experiencing hair loss (just look in your local pharmacy and notice all the products on the market designed for women’s thinning hair.. those products are there because there’s a huge market for them). So while you may feel alone, because this issue is not openly discussed, please know that you are not!
August 14th, 2006
One of our loyal users known as “Trey” was kind enough to allow us to post this information on an article found in the latest issue of Scientific American (June 2001). We strongly suggest you pick up a copy yourself so that you can review the entire thing uninterrupted. The “clippings” below should give some peeks into the latest discoveries and insights in the medical community regarding the understanding of hair loss and hair growth. Enjoy …
The best news to me was that it played up on the fact that the follicles never die as once believed, but rather shrink and stay in the dormant stage. Also it’s interesting to see the research that is being done on these various stages and how all of this ties in to the original formation of the follicles in an embryo. Also the tone of the article is positive regarding future treatments and the attitudes of those who are currently researching this (as you will see).
For those of you who are new to hair loss research some of this might sound like Greek, but many of you will understand exactly what is being said here. These quotes are taken from various parts of the article, and I divided the quotes into three main categories (Follicles Don’t Die; Research Highlights; The Outlook)
~ Trey
The (MPB) Follicle Doesn’t Die:
“The good biological news is that in the most common types of thinning, hair follicles don’t die. In classic male- and female-pattern hair loss (androgenetic alopecia), for instance, follicles become miniaturized and their growing phase abbreviated; they then produce extremely short, fine hairs. ‘Even guys who are bald still have little hairs on the top of their head,’ explains Bruce. A Morgan of Harvard’s Cutaneous Biology Research Center.” (MS) p. 76
“Hair thinning generally happens not because follicles disappear, but because the ratio of follicles in the growing and non-growing phases shifts unfavorably. Also, many follicles in balding people shrink progressively, ultimately producing only small, colorless hairs.” p. 74
“Baldness often arises not because follicles die but because they shrink and malfunction. Drugs that manipulate Wnts or other regulatory proteins might one day protect threatened follicles and prod shrunken ones into producing hair normally again.” p. 72
“Last year Ronald G. Crystal of Weill Medical College of Cornell University found that when hair follicles in adult mice are induced to make the protein during the resting, telogen stage, the follicles shift prematurely into the hair-producing, anagen stage. Thus, sonic hedgehog can stimulate dormant follicles to begin producing hair.” p. 79
“As researchers become more sophisticated in their knowledge of the molecular interactions underlying hair growth, they can begin animal testing of compounds that might restore order to deranged regulatory pathways and revive dormant follicles.” p. 79
Research Highlights:
“To trace the molecular controls over any given process, scientists first need to know the basic outlines of the process itself. By 1995 microscopists and others had developed a good sketch of the incredible steps that lead to the formation of hair follicles in the developing embryo. They had also described the hair cycle — the periodic phases during which follicles produce or stop producing hair; follicles undergo this cycle repeatedly in a lifetime.” p. 72
“Anagen follows telogen. Early on some of the stem cells from the bulge divide and travel down along the basement membrane to become matrix or outer root sheath cells. Once formed, the matrix cells proliferate and ultimately give rise to the hair cells and the inner root sheath, repeating the steps that occur during the embryonic development. This repetition implies that the events of anagen are probably controlled by a number of the same signaling molecules that operate during development.” p. 74
“As is true during follicle development in the embryo, during the anagen signals from the dermal papilla instruct the matrix cells to divide and subsequently differentiate into hair cells. For this reason, scientists have become very interested in uncovering the nature of the signals issued by the dermal papilla during development and cycling. They don’t have the answer yet, but in the past few years Elaine Fuchs and her colleagues at the University of Chicago have discovered that the dermal papilla’s signals probably convey their directives largely by activating still other signaling molecules — members of the Wnt family of proteins. Wnt proteins have long been recognized as key regulators of varied developmental processes in mammals and other organisms.” p. 74-75
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“Fuchs began her search for the molecules that dictate the conversion of matrix cells to hair cells by trying to identify the molecules in the nucleus that switch on the hair keratin genes. In 1995 her group discovered that a regulatory protein called lymphocyte enhancer factor 1 (LEF1) participated in activating the hair keratin genes. It was also present during hair follicle formation in the embryo, where it appeared in the earliest clusters of ectoderm cells as well as in the cells destined to form the dermal papilla.” p. 75
“…without LEF1, mice fail to make a furry coat. And when Fuchs’s team engineered mice that produced excess LEF1 in the skin, the animals produced more hair follicles than normal.” p. 75 (you’ve all read that online article, I’m sure — http://news.bbc.co.uk/hi/english/sci/tech/newsid_221000/221359.stm — Trey)
“LEF1 cannot activate genes on its own; rather it must first couple with a second protein, beta-catenin. The only mechanism known to trigger this coupling was the activation of the signaling cascade that begins with the binding of a Wnt molecule to the cell surface. Beta-catenin normally helps to form junctions with neighboring cells. In the absence of Wnt signaling, an enzyme inside the cells marks any unused beta catenin for destruction. Wnts instruct cells to handcuff that enzyme. With the enzyme out of commission, beta-catenin becomes free to accumulate and to pair with LEF1 or one of its relatives.” p. 75
“Those experiments implied that Wnt is the mesoderm-issued signal that instructs the overlying ectoderm to begin forming an appendage and is likewise the ectodermal signal that tells the underlying mesoderm to form the dermal papilla. What is more, much later in development, after follicles have formed, Wnt appears to be the message that directs matrix cells above the dermal papilla to differentiate into hair cells.” p. 76
“As adults, these rodents [mentioned earlier — Trey] acquired an unusually lush coat by forming new follicles between the ones that were laid down during the embryonic development… As the furry rodents aged, they acquired benign lumps that resembled a common human scalp tumor called pilomatricoma. Fuchs’s laboratory subsequently demonstrated that in humans these tumors arise when a mutation in the beta-catenin gene prevents the protein’s breakdown.” p. 77
“Wnts are major regulators of follicle development and cycling but…simply delivering Wnts by constant application would not be feasible as a human therapy, because of the tumor risk. The trick to correcting hair maladies, Fuchs contends, may be to deliver Wnts in a pattern that mimics nature better or to manipulate other steps in the Wnt signaling cascade.” p. 78
[If other tests go well…] “…human scalp skin can be transplanted onto mice incapable of rejecting it to determine whether human and mouse follicles respond comparably to the agents. And if those results are good, investigators may attempt human trials of the most promising drug candidates.” p. 79
The Outlook:
“‘We don’t have a product yet that’s going to be ‘wow!’ for over 50 percent of people she [Marty Sawaya] notes. I do think dutasteride will be that product if the company goes forward.’…GlaxoSmithKline may choose to pursue it first as a prostate drug, as happened with finasteride.” p. 77 (MS)
“Scientists are on the prowl for new drugs all the time….Michael Detmar discovered earlier this year that abundant amounts of a growth factor that increases the blood supply make mice grow hair faster and thicker. Now…the hunt is on for small molecules that will either mimic or activate the factor.” p. 77 (MS)
“A fundamental understanding of hair biology may someday let physicians replace a defective gene in hair follicles through gene therapy or grow hairs in a petri dish for use in graft surgery. ‘The complexity of the question is like understanding how a limb forms. It’s ambitious. But we are discovering a lot and discovering a lot quickly,’ muses Kurt S. Stenn, chief scientific officer of Juvenir Biosciences, a company recently spun off from Johnson & Johnson to focus predominantly on hair research. ‘This is a wonderful time to be working in hair biology. So many breakthroughs are coming.’” p. 77 (MS)
“No one can predict how soon dermatologists and pharmaceutical companies will be able to produce new therapies built on the discoveries emerging from basic research into hair follicle development and cycling. But that research is progressing remarkably fast. If the pace continues, Fuchs predicts, much of the information that is needed to understand the complex controls on hair manufacture will probably be in hand within the next five years.” p. 79
August 10th, 2006
Many of you just starting to experience the first signs of hair loss tend to become gung-ho about dumping on the treatments. Many of your regimens are the same regimens men who have already lost a significant amount of hair are using to regrow entire sections of their scalp hair. However, preventing hair loss is nowhere near as difficult as regrowing lost hair, and its likely that you do not need so many treatments just to maintain what you have…
Propecia, the current wonder drug, has an incredibly high success rate (83%) of maintaining men’s hair counts. Propecia use alone has saved hundreds of thousands of men from a future of baldness, without the help of any other treatments at all. These men are fortunate, because they have an entire arsenal of treatments to add if or when Propecia ever stops working for them.
Pathology of male pattern hair loss
Androgen-dependent skin conditions, such as male pattern hair loss (androgenetic alopecia, AGA) and acne, are among the dermatologic conditions most frequently encountered by the specialist and the general physician. AGA is the commonest form of human alopecia, affecting more than 50% of men by the age of 50 years, and a smaller but still significant proportion of women by the same age. Historically, the clinical management of AGA has been limited to the psychologic support of the client, and the use of cosmetics that thicken the remaining hair, or make the scalp less conspicuous. Hair systems (swatches, weaves, and wigs), and surgical procedures including punch grafts, follicular unit transplantation, and flap surgery are also widely used. In recent years however, drug therapy has increasingly become a realistic management option, as our understanding of the mechanisms of normal and pathologic hair growth has pointed the way to improved treatments.
The changes that occur in the distribution of scalp hair as AGA progresses follow a course that has been well documented in both sexes, as have the changes in the scalp and scalp hair that are commonly found to occur in male pattern hair loss. The most important recent development in our understanding is the recognition that androgens play a central role in the development of AGA. It has been observed that castrated men do not exhibit AGA; however, if they are given exogenous androgens, they will reversibly show signs of hair loss. Several recent lines of evidence implicated DHT, a metabolite of testosterone, as the active metabolite in AGA. The enzyme responsible for the conversion of testosterone to DHT is 5a-reductase.
Psychology of hair loss, prevention, and regrowth
Hair forms a vital element of an individual’s physical appearance, and changes in the hair, including its loss, can have correspondingly profound effects on interpersonal reactions and on self image. Studies that have specifically addressed the psychosocial impact of hair loss in men have shown that men with visible hair loss are perceived as older, weaker, and less physically attractive than their nonbalding counterparts. Not surprisingly, such adverse social stereotyping of individuals with hair loss has a considerable impact on the self image, and therefore on the quality of life, of men with AGA. Studies confirm that the negative self-perception of hair loss by others is reflected in the psychologic responses of balding men to their own condition. Using standard psychologic tests, men with AGA report experiencing distress about their hair loss, feeling less physically attractive, and having greater body image dissatisfaction than their nonbalding peers.
Given that many men are strongly motivated to seek help with their AGA, the treatment objectives may variously include the prevention of further hair loss, the maintenance of existing hair, the regrowth and retention of lost hair, or any combination of the three.’ In most cases, however, prevention and maintenance are the most realistic therapeutic options. In this context, it must be recognized that there is frequently a disparity between what the physician assumes are the patient’s needs or requirements, and what the patient actually expects. Although there is a lack of rigorous scientific studies of men’s attitudes towards regrowth of their lost hair as compared to the prevention of further hair loss, some indications are available in the literature. For example, in a study in which men with AGA completed the Hair Loss Effects Questionnaire (HLEQ), a high proportion gave responses that were directed towards a future rather than a present state: 93% worried about how much hair they would lose, 87% reported trying to estimate if they were losing more hair, and 8o% tried to imagine how they would look with more hair loss Cash” has also reported that balding men who anticipated more hair loss in the future experienced significantly greater negative events and cognitive preoccupation, and were also less satisfied with their hair and overall appearance than men who anticipated minimal future hair loss.
Some anecdotal evidence, based on market research among 2200 men with at least some degree of hair loss, strongly supports the importance of prevention rather than regrowth to the patient. Thus, when asked directly whether they were more concerned about the amount of hair they currently had (i.e. regrowth) or the rate at which they were losing it (i.e. prevention), most respondents (61%) were equally concerned about the two; of those expressing a greater concern for one or the other, two-thirds were more concerned with prevention and one-third with regrowth. Although the ideal for most of the men involved in this research would clearly be a hair treatment that produced both regrowth and prevention, slightly more respondents thought that prevention (43%) rather than regrowth (34%) was essential in a hair loss treatment.
Therefore, it seems that many men are more anxious to prevent further hair loss in the future than they are to regrow the hair they have already lost. Nonetheless, physicians may incorrectly believe that the patient will only be satisfied with overt regrowth, when in fact he would be content with retaining his remaining hair. This is an important point because secondary prevention, that is the prevention of further loss, is currently a more realistic treatment goal for the physician to offer. This is demonstrated by the drug treatments that have been or are now available.
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Drug treatments: Minoxidil
The antihypertensive drug minoxidil was shown in the early 1980’s to stimulate new hair growth, and was eventually approved as a topical treatment for AGA in men and women. Minoxidil is known to act as an opener of potassium channels, but the mechanism by which it exerts its effect on hair is unclear, as it is a vasodilator with no known antiandrogenic activity. It appears to convert vellus to terminal hairs, to normalize the hair follicular morphology, and to increase the number of follicles in mid to late anagen, the growth phase of the hair cycle Multicenter clinical trials have demonstrated the efficacy of minoxidil in AGA: in most patients treated with topical minoxidil 2% or 3% for 12 months, mean hair counts increased, and in some patients hair counts continued to increase for some time afterwards. 19-3
Topical minoxidil 2% nevertheless has only limited success and the individual response is highly variable. Recent clinical trials with topical minoxidil 5% have shown promising results: in one study, 54% of treated patients showed an increase in hair counts, compared to 29 % of patients on placebo.
Minoxidil has not been approved for systemic use because of potentially serious side-effects, notably cardiovascular, due to its antihypertensive action, and because extraneous hair growth has occasionally been seen even with topically applied minoxidil thought to be due to absorption and systemic action.
Furthermore, as discussed earlier, the majority of men appear to be more concerned with prevention of further hair loss than with regrowth: Minoxidil has not shown any preventive activity, and its ability in the long term to retain new growth against a background of genetically associated hair loss has not been demonstrated.
Drug treatments: manipulating androgen metabolism to retard male pattern hair loss
The most promising treatments modulate the metabolism of androgens in the scalp. Currently, only one pharmaceutical is available to the physician for the treatment of men with AGA. Finasteride (Propecia) is a potent, specific inhibitor of the type 2 5a-reductase that is responsible for the conversion of testosterone to DHT. Given orally, Finasteride reduces DHT levels systemically and in the target tissues (i.e. scalp). In an animal model of AGA, the stump-tailed macaque, daily oral Finasteride given over a period of 6 months significantly reduced circulating DHT levels and increased scalp hair weight. 8 Finasteride at a dosage of 1 mg/day has recently been approved by the Food and Drug Administration (FDA) for the treatment of male pattern hair loss in men. Its efficacy has been demonstrated in three double-blind, placebo-controlled, randomized studies. Men with AGA, aged between 18 and 41 years, were given either oral Finasteride 1 mg/day or a placebo. Assessed by scalp hair counts, self-assessment by patients using a validated questionnaire, investigator assessment using a standardized seven-point rating scale of hair growth from baseline, and an independent expert review of photographs taken every 6 months, Finasteride treatment was evaluated as resulting in improvement. Finasteride produced a progressive increase in hair counts at 6, 12 and 24 months, while placebo treatment resulted in significant hair loss. By 24 months, 72% of patients on placebo had lost hair compared to baseline, while 83% of patients on Finasteride had experienced no further hair loss. Similarly, at 14 months, the expert panel considered 66% of Finasteride-treated patients greatly, moderately, or slightly improved vs. only 7% of those on placebo. There was little difference in the incidence of side-effects reported by men on Finasteride (4.2%) vs. placebo (2.2%) which resolved after discontinuation and in many of the men who remained on drug treatment.
These results are in line with our current understanding of the effect of DHT on hair physiology. Although, as mentioned previously, the molecular details of the mechanism by which androgens affect hair growth are not known, it is apparent that, in the androgen-sensitive scalp of genetically susceptible individuals, they cause a gradual miniaturization of the follicles and conversion of long, thick pigmented terminal hair to short, fine, unpigmented vellus hair. Prevention of the androgen-mediated miniaturization will inhibit or retard the process leading to hair loss, and in some cases result in new hair growth. Furthermore, there is demonstrable heterogeneity in 5a-reductase activity in scalp hair roots from patients with AGA, which may account for some of the variation in response to Finasteride.
Conclusions
The likelihood is that the modulation of androgen metabolism will prevent further hair loss in the majority of patients, and induce hair growth in a smaller proportion, depending on the extent of their condition and their genetic background. It is vital therefore for the prescribing physician to bear in mind that the patient may suffer anxiety over the possible progression of hair loss in the future, while being able to tolerate his present condition. For many patients, prevention of further hair loss alone will constitute acceptable management. For the physician, the important message is that the best therapeutic prospects lie in drug modalities that utilize our increased understanding of normal and pathologic hair growth. Although topical minoxidil was the first effective drug to benefit some of these patients, targeting of type 2 5a-reductase in the scalp hair follicle using oral Finasteride is now a realistic option for the prevention of further hair loss in the patient with male pattern baldness.
Marcia Ramos-e-Silva, MD, PhD International Journal of Dermatology
August 7th, 2006
The marketplace now offers men their own beauty products, and, according to a new Glamour poll, men are using them.
Men account for 10 percent of cosmetic sales, according to the magazine’s August issue, which also reports that 63 percent of 1,529 women polled said their man buys and uses skin and hair products.
Another survey, conducted for Boss Skin, a new men’s grooming line from Hugo Boss, found that 36 percent of the 559 men questioned knew their skin should be moisturized, but only 10 percent said they washed, exfoliated and moisturized each day.
Fekkai Salon stylist Stephane Andre offers tips for men:
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•Don’t try too hard. Keep your look simple.
•Exfoliate scalp once a week, since clogged pores can be attributed to hair loss. Shampoo and conditioner should be used after exercise because salt deposits from sweat leave hair dry.
•Cut hair every six weeks. If hair is thinning, keep it short.
•For a more natural look when you start to gray, don’t color it completely. If a little gray shows through, it won’t look as fake.
•A small amount of gel, wax or pomade will make hair shinier, but don’t overdo it.
Some of the rules for hair are the same for skin care, too. A skin care routine should include cleansing, exfoliating, moisturizing and using sunscreen, said Matthew Teri, vice president at Lab Series for Men.
His suggestions:
•Skin should be cleaned twice a day. Men produce more sebum and therefore have oilier skin.
•Exfoliation unclogs pores, smoothing the texture in preparation for shaving. It also allows for better absorption of moisturizers.
•A lightweight moisturizer likely will keep skin balanced.
•Sunscreen should be applied daily, even on cloudy days, to protect skin from harmful ultraviolet rays. Same goes for earlobes and scalp, especially if hair is thin. •
August 3rd, 2006